Secukinumab dosing every 2 weeks demonstrated superior efficacy compared with dosing every 4 weeks in patients with psoriasis weighing 90 kg or more: results of a randomized controlled trial. (1st June 2022)

• Record Type: Journal Article
• Authors: Augustin, Matthias; Reich, Kristian; Yamauchi, Paul; Pinter, Andreas; Bagel, Jerry; Dahale, Swapnil; You, Ruquan; Bruin, Gerard; Djimopoulos, Jimena; Paguet, Bertrand; Charef, Pascal; Patekar, Manmath; Keefe, Deborah
• Is Part Of: British journal of dermatology. Volume 186:Number 6(2022)
• Page Start: 942
• Page End: 954
• Publication Date: 2022-06-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.20971
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Obesity is a common comorbidity of psoriasis and can attenuate response to biologic treatment. Objectives: To investigate the efficacy, safety and tolerability of secukinumab 300 mg every 2 weeks (Q2W) vs. secukinumab 300 mg every 4 weeks (Q4W) in patients with a higher bodyweight. Methods: In this multicentre, double‐blind, parallel‐group trial, 331 patients with moderate‐to‐severe chronic plaque psoriasis weighing ≥ 90 kg were randomized to receive secukinumab 300 mg Q2W or secukinumab 300 mg Q4W. Patients who did not achieve Psoriasis Area and Severity Index (PASI) 90 at week 16 on the Q4W regimen were reallocated to remain on the Q4W regimen or uptitrate to Q2W. Results: At week 16, Q2W dosing (n = 165) led to significantly higher PASI 90 responses vs. Q4W [n = 166; 73.2% vs. 55.5%, one‐sided P‐value = 0.0003, odds ratio estimate (95% confidence intervals): 2.3 (1.4–3.8)]. At week 52, higher efficacy responses were maintained in the Q2W arm (n = 165) vs. Q4W (n = 83); PASI 75: 88.9% vs. 74.8%; PASI 90: 76.4% vs. 52.4%; PASI 100: 46.7% vs. 27.3%; Investigator's Global Assessment 0/1: 75.9% vs. 55.6% and Dermatology Life Quality Index 0/1: 66.1% vs. 48.8%. PASI 90 nonresponders at week 16 who uptitrated to Q2W (n = 31) showed higher efficacy responses at week 32 (16 weeks post‐uptitration, PASI 90: 38.7% vs. 16.5%) vs. those who remained on Q4W (n = 40). Safety results were comparable across treatment arms and consistent with the established secukinumab safety profile. Conclusions: Secukinumab 300 mg Q2W demonstrated superior and sustained efficacy compared with Q4W in patients with moderate‐to‐severe plaque psoriasis weighing ≥ 90 kg. PASI 90 nonresponders derived additional benefits from uptitration to a Q2W regimen (ClinicalTrials.gov identifier: NCT03504852).